Knowledge, attitudes and practices towards lung cancer among adults in KwaZulu-Natal, South Africa: a cross-sectional survey
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Background. Lung cancer remains the number one cause of cancer mortality estimated at 1.8 million deaths. There are limited studies in resource poor countries regarding knowledge, attitudes and practices towards lung cancer.
Objective. This study aimed to describe the knowledge, attitudes and practices regarding lung cancer in selected communities in KwaZulu- Natal, South Africa. Methods. An observational, analytic cross-sectional study design was conducted using a standardized questionnaire. A stratified random cluster sampling method was applied across five communities. A regression model was developed to identify the predictors of the level of knowledge.
Results. About 59.9% (95% CI 52.0 - 67.3) of the participants reported to have heard of lung cancer. The mean knowledge score was 41.8% (95% CI 35.7 - 47.9%). Coughing blood was the most recognized symptom (61.0%, 95% CI 52.1 - 69.1). About 17% (95% CI 14.7 - 21.5) of participants reported to be smokers. Many respondents reported that they would go to a health centre or clinic in case they were coughing blood (72.4%, 95% CI 93.9 - 79.5). Less than 10% (95% CI 3.9 - 8.1) of participants was screened for lung cancer at the time. Gender, history of working in the chemicals industry, screening for lung cancer, and time taken to seek health care when sick were significant predictors of lung cancer knowledge.
Conclusions. Public health interventions should be explored to increase the levels of community awareness regarding lung cancer, particularly focusing on the importance of screening, early diagnosis and treatment.
Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA oncology. 2017;3(4):524-48. DOI: https://doi.org/10.1001/jamaoncol.2016.5688
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer. 2015;136(5).
Fidler MM, Soerjomataram I, Bray F. A global view on cancer incidence and national levels of the human development index. International journal of cancer. 2016;139(11):2436-46. DOI: https://doi.org/10.1002/ijc.30382
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics, 2012. CA: a cancer journal for clinicians. 2015;65(2):87-108. DOI: https://doi.org/10.3322/caac.21262
Ferlay J, Shin H-R, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893-917. DOI: https://doi.org/10.1002/ijc.25516
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86. DOI: https://doi.org/10.1002/ijc.29210
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;0(0). DOI: https://doi.org/10.3322/caac.21492
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021. DOI: https://doi.org/10.3322/caac.21660
Islami F, Torre LA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Translational lung cancer research. 2015;4(4):327.
Smith P, Smits S, Owen S, Wood F, McCutchan G, Carter B, et al. Feasibility and acceptability of a cancer symptom awareness intervention for adults living in socioeconomically deprived communities. BMC Public Health. 2018;18(1):695. DOI: https://doi.org/10.1186/s12889-018-5606-3
Loh JF, Tan SL. Lung cancer knowledge and screening in the context of the Malaysian population. JPPR Journal of Pharmacy Practice and Research. 2018;48(1):56-64. DOI: https://doi.org/10.1002/jppr.1341
Schluger NW, Koppaka R. Lung disease in a global context. A call for public health action. Annals of the American Thoracic Society. 2014;11(3):407-16. DOI: https://doi.org/10.1513/AnnalsATS.201312-420PS
Tanner NT, Egede LE, Shamblin C, Gebregziabher M, Silvestri GA. Attitudes and beliefs toward lung cancer screening among US Veterans. Chest. 2013;144(6):1783-7. DOI: https://doi.org/10.1378/chest.13-0056
Zeliadt SB, Heffner JL, Sayre G, Klein DE, Simons C, Williams J, et al. Attitudes and Perceptions About Smoking Cessation in the Context of Lung Cancer Screening. JAMA Internal Medicine. 2015;175(9):1530-7. DOI: https://doi.org/10.1001/jamainternmed.2015.3558
Morhason-Bello IO, Odedina F, Rebbeck TR, Harford J, Dangou JM, Denny L, et al. Challenges and opportunities in cancer control in Africa: a perspective from the African Organisation for Research and Training in Cancer. Lancet Oncol. 2013;14(4):e142-51. DOI: https://doi.org/10.1016/S1470-2045(12)70482-5
Williams CK, Cristina Stefan D, Rawlinson F, Simbiri K, Mbulaiteye SM. The African Organisation for Research and Training in Cancer and its conferences: a historical perspective and highlights of the Ninth International Conference, Durban, South Africa, 21-24 November 2013. Ecancermedicalscience. 2014;8:396.
Kingham TP, Alatise OI, Vanderpuye V, Casper C, Abantanga FA, Kamara TB, et al. Treatment of cancer in sub-Saharan Africa. The Lancet Oncology. 2013;14(4):158-67. DOI: https://doi.org/10.1016/S1470-2045(12)70472-2
Abner Ellapen J. The cinematic township: cinematic representations of the ‘township space’ and who can claim the rights to representation in post-apartheid South African cinema. Journal of African Cultural Studies. 2007;19(1):113-38. DOI: https://doi.org/10.1080/13696810701485967
Southern Africa Labour and Development Research Unit. National Income Dynamics Study Wave 3, 2012 [dataset]. Version 3.0.0. Pretoria: SA: Cape Town: Southern Africa Labour and Development Research Unit [implementer], 2016. Cape Town: DataFirst [distributor]; 2016.
Simon AE, Juszczyk D, Smyth N, Power E, Hiom S, Peake MD, et al. Knowledge of lung cancer symptoms and risk factors in the U.K.: development of a measure and results from a population-based survey. Thorax. 2012;67(5):426-32. DOI: https://doi.org/10.1136/thoraxjnl-2011-200898
Wright A. REDCap: A Tool for the Electronic Capture of Research Data. Journal of Electronic Resources in Medical Libraries. 2016;13(4):197-201. DOI: https://doi.org/10.1080/15424065.2016.1259026
Zainuddin N, Thabit H. Knowledge and perception on lung cancer and its screening: A study among undergraduate students of the International Islamic University Malaysia, Kuantan Campus. Journal of Biomedical and Clinical Sciences (JBCS). 2018;2(2):61-6.
Shankar A, Roy S, Malik A, Rath GK, Julka PK, Kamal VK, et al. Level of Awareness of Various Aspects of Lung Cancer Among College Teachers in India: Impact of Cancer Awareness Programmes in Prevention and Early Detection. Journal of Cancer Education. 2016;31(4):709-14. DOI: https://doi.org/10.1007/s13187-015-0960-7
Al-Naggar RA, Kadir SYA. Lung cancer knowledge among secondary school male teachers in Kudat, Sabah, Malaysia. Asian Pacific Journal of Cancer Prevention. 2013;14(1):103-9. DOI: https://doi.org/10.7314/APJCP.2013.14.1.103
Chawla R, Sathian B, Mehra A, Kiyawat V, Garg A, Sharma K. Awareness and assessment of risk factors for lung cancer in residents of Pokhara Valley, Nepal. Asian Pacific journal of cancer prevention : APJCP. 2010;11 6:1789-93.
Crane M, Scott N, O'Hara BJ, Aranda S, Lafontaine M, Stacey I, et al. Knowledge of the signs and symptoms and risk factors of lung cancer in Australia: mixed methods study. BMC public health. 2016;16. DOI: https://doi.org/10.1186/s12889-016-3051-8
Lee G-M, Yoon J-H, Lee W-R, Kim L-H, Yoo K-B. Factors Associated With the Differences Between Self-Report Smoking and Urinary Cotinine Criteria. Asia Pacific Journal of Public Health. 2021:1010539520986248. DOI: https://doi.org/10.1177/1010539520986248
Chapple A, Ziebland S, McPherson A. Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. BMJ: British Medical Journal. 2004;328(7454):1470-3. DOI: https://doi.org/10.1136/bmj.38111.639734.7C
Blecher E, Ross H. Tobacco use in Africa: tobacco control through prevention. Atlanta, GA: American Cancer Society. 2013.
Quaife SL, Marlow LAV, McEwen A, Janes SM, Wardle J. Attitudes towards lung cancer screening in socioeconomically deprived and heavy smoking communities: informing screening communication. Health Expectations. 2017;20(4):563-73. DOI: https://doi.org/10.1111/hex.12481
Corner J, Hopkinson J, Fitzsimmons D, Barclay S, Muers M. Is late diagnosis of lung cancer inevitable? Interview study of patients’ recollections of symptoms before diagnosis. Thorax. 2005;60(4):314. DOI: https://doi.org/10.1136/thx.2004.029264
Quaife SL, Forbes LJL, Ramirez AJ, Brain KE, Donnelly C, Simon AE, et al. Recognition of cancer warning signs and anticipated delay in help-seeking in a population sample of adults in the UK. British journal of cancer. 2014;110(1):12-8. DOI: https://doi.org/10.1038/bjc.2013.684
Birt L, Hall N, Emery J, Banks J, Mills K, Johnson M, et al. Responding to symptoms suggestive of lung cancer: a qualitative interview study. BMJ Open Respir Res. 2014;1(1):e000067-e. DOI: https://doi.org/10.1136/bmjresp-2014-000067
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